5 Tips and Tricks for a More Efficient and Effective Comprehensive Dental Cleaning Procedure
Performing a dental cleaning procedure can be a challenge, especially if it is one those crazy, busy days at the practice and you’re being pulled in 10 directions. That’s most days, right!?! Here a few tips that will help with those dental cleanings.
1. Take Radiographs First
When you take the radiographs as the first step of your professional dental procedure, you give the veterinarian time to carefully review the x-rays, decide on a treatment plan and contact the owner if necessary, while you are completing the dental cleaning process. Remember that x-rays are a vital part of a comprehensive oral examination. Our patients can’t tell us where it hurts, so we need to look for pathology that may be only visible on a radiograph. If there excessive amounts of calculus is present, you may want to “pop” it off before you take the x-rays, but frankly it has never been a problem in my hands.
2. Reducing the Bacterial Load in the Mouth
When the oral examination is complete and the mouth has been charted, take a soft bristled toothbrush and thoroughly brush all of the teeth. This can be done with water alone or with prophy paste. Once the teeth are brushed use the air/water syringe and using both water and air and “power wash” the mouth. Tooth brushing alone will dramatically reduce the amount of plaque and the bacterial load in the mouth. In addition to removing plaque it can remove any other debris that may be in the mouth, such as hair, food particles and other unpleasant materials. Soak the toothbrush in chlorhexidine solution during the procedure and then send it home with the pet.
Rationale: Ultrasonic scaling will result in aerosolization of the bacteria in the mouth and studies show that the bacteria can remain in the operatory for up to 8 hours. Brushing first not only reduced the bacterial load but it removes much of the debris allowing for easy visualization of the calculus that requires a scaler to remove. When the plaque and debris is removed, the technician can go directly to the calculus present with the scaler, saving time on the cleaning procedure and resulting in less time on each tooth preventing thermal damage.
3. Scaler Tips
Use the correct tip of the scaler for the different parts of the tooth. Many people use only the Universal tip and feel it is sufficient to clean the entire oral cavity. The name implies that it is to be used everywhere on the tooth however this tip is not as effective on cleaning the crown and not effective below the crown due to the size of the tip. Changing the tips will result in faster cleaning times. Use the “beaver tail” or gross debris tip to clean the crown of the teeth. This tip is only designed to clean the crowns of the teeth and should never be used below the gumline. Clean all accessible crown surfaces with this tip before changing to the periodontal tip. The periodontal tip has a fine tip that is designed to go below the gumline.
Rationale: The advantage of using this tip, in addition to a curette, to clean out periodontal pockets is the fact that the ultrasonic waves burst the cell walls of the bacteria and break up calculus that has formed under the gums and the water flushes the debris from the pocket. The use of the correct tip reduces the amount of time required to perform the task. It only takes a few seconds to change the tips but the time saved by using the correct tool for the job is huge.
4. Power Scaler Technique
Use a very light grip on the hand piece remembering that your hand is only a guide for the tip. Using pressure or force only decreases the working power of the tip and can result in thermal damage to the tooth. Stay in constant contact with the tooth when scaling as the constant off and on action can cause a concussive injury to the tooth.
A good rule of thumb is to spend no more than seven seconds on a tooth before moving on to other teeth allowing the tooth to cool down. After cleaning several other teeth, the technician can return to the tooth if additional cleaning is required
Rationale: Power scalers range in speed from 8000 to 45,000 cycles/second resulting in an extreme amount of heat being generated. By limiting the pressure used and the amount of time spent on each tooth, the risk of thermal damage to the tooth is decreased.
5. Prophy Paste
Using the correct prophy paste is an important step in the cleaning process. It is recommended to use either fine or flour grit paste for the dental cleaning. You can purchase premade fine paste or make your own paste using flour pumice and glycerin and mixing it to a thick “cookie dough” consistency. Flour pumice can be purchased for your distributor.
Spend as much time polishing each tooth as spent scaling the tooth. The polisher does produce heat so spend no more than seven seconds on a tooth before moving on to other teeth. You can always come back to that tooth to finish. The prophy angle speed should be slow (3000 to 8000 rpms) and move the prophy cup slowly allowing the cup and paste to do the work. Using too high of rpms can result in thermal damage to the tooth and using too fast of movement will not result in a smooth surface.
Rationale: The ultrasonic scaler will leave micro etches on the tooth surface. These etches are the perfect location for bacteria to hide and propagate leading to more plaque and more calculus. Polishing is done to smooth those etches out giving less surface area for the plaque to adhere. Much like sandpaper, the courser grit of polish you have the more etches that may occur. Therefore it is important to use only fine or flour grit pumice to return that enamel to the smooth surface that was intended.
These are a few tips to help not only speed up the cleaning procedure but ensure that the procedure is a safe one for you and the patient.
About Mary Berg: BS, RVT, LATG, VTS (Dentistry)
Mary received her B.S. in Biology/Microbiology from South Dakota State University, her A.S. in Laboratory Animal Science from Redlands Community College, and her A.S. in Veterinary Technology from St. Petersburg College. She is a Charter member of the Academy of Veterinary Dental Technicians and received her Veterinary Technician Specialty in Dentistry in June 2006. Mary is currently serving as the treasurer of the AVDT, the President-elect of the KVTA, and is the 2017 President for NAVTA.
Mary fell into this profession totally by accident. After graduating from SDSU and following her military husband around the world, they settled in Lawrence, KS. She applied for a job as a microbiology lab assistant but wasn’t hired due to lack of experience. However, the company saw that she had held many administrative and management positions since graduation so they offered her a position as an administrative assistant for a research company that conducted research for companion animal oral products. Her career took off from there moving up to Vice President of Operations, all the while working as a researcher developing and implementing protocols to access the efficacy of products on plaque and calculus accumulations in dog and cats. . She spent 13 years in research and continues to work with companies to evaluate their products and serves on the VOHC council. In addition to her research background, she was the practice manager and dental specialist at a general practice for over 7 years, taught veterinary technology for 2 years and is currently the president of Beyond the Crown Veterinary Education, a veterinary dental consulting service as well as a national and international speaker and writer.
The most difficult part of her job is her chronic, genetic, inability to say no. She truly enjoys spreading the dental gospel and it’s hard to step back even when her schedule is full. The best thing about her job is that she gets the opportunity to meet so many wonderful people and help so many more pets than she did working in practice. She can now ensure that housands of pets get good oral care by helping the doctors, technicians and staff, understand the importance of providing good dental care to their patients. Her goal is to continue to spread the word of dentistry to all practices in the United States and elsewhere. She will be happy when each veterinary practice is doing a thorough oral examination, taking a full series of x-rays and understanding how to treat or when to refer pathology that is found!
Her advice to technicians is to get as much CE as possible, get involved in your professional organizations either at a local, state or national level and NEVER say no to an opportunity.
Mary lives on a small farm in Kansas with her husband and enjoys spending time relaxing at her pool with her grandchildren and menagerie of pets. When she’s not working she love to garden and along with her husband use the produce from the garden to create salsas, jellies, jams and other tasty treats as gifts for friends.
Her favorite textbook is Small Animal Dental Procedures for Veterinary Technicians and Nurses edited by Jeanne Perrone. Of course, chapter 2 is her favorite!! Wink, wink! Her favorite non-veterinary books include mostly murder mystery thrillers and the occasional mindless romance!
Performing a dental cleaning procedure can be a challenge, especially if it is one those crazy, busy days at the practice and you’re being pulled in 10 directions. That’s most days, right!?! Here a few tips that will help with those dental cleanings.
1. Take Radiographs First
When you take the radiographs as the first step of your professional dental procedure, you give the veterinarian time to carefully review the x-rays, decide on a treatment plan and contact the owner if necessary, while you are completing the dental cleaning process. Remember that x-rays are a vital part of a comprehensive oral examination. Our patients can’t tell us where it hurts, so we need to look for pathology that may be only visible on a radiograph. If there excessive amounts of calculus is present, you may want to “pop” it off before you take the x-rays, but frankly it has never been a problem in my hands.
2. Reducing the Bacterial Load in the Mouth
When the oral examination is complete and the mouth has been charted, take a soft bristled toothbrush and thoroughly brush all of the teeth. This can be done with water alone or with prophy paste. Once the teeth are brushed use the air/water syringe and using both water and air and “power wash” the mouth. Tooth brushing alone will dramatically reduce the amount of plaque and the bacterial load in the mouth. In addition to removing plaque it can remove any other debris that may be in the mouth, such as hair, food particles and other unpleasant materials. Soak the toothbrush in chlorhexidine solution during the procedure and then send it home with the pet.
Rationale: Ultrasonic scaling will result in aerosolization of the bacteria in the mouth and studies show that the bacteria can remain in the operatory for up to 8 hours. Brushing first not only reduced the bacterial load but it removes much of the debris allowing for easy visualization of the calculus that requires a scaler to remove. When the plaque and debris is removed, the technician can go directly to the calculus present with the scaler, saving time on the cleaning procedure and resulting in less time on each tooth preventing thermal damage.
3. Scaler Tips
Use the correct tip of the scaler for the different parts of the tooth. Many people use only the Universal tip and feel it is sufficient to clean the entire oral cavity. The name implies that it is to be used everywhere on the tooth however this tip is not as effective on cleaning the crown and not effective below the crown due to the size of the tip. Changing the tips will result in faster cleaning times. Use the “beaver tail” or gross debris tip to clean the crown of the teeth. This tip is only designed to clean the crowns of the teeth and should never be used below the gumline. Clean all accessible crown surfaces with this tip before changing to the periodontal tip. The periodontal tip has a fine tip that is designed to go below the gumline.
Rationale: The advantage of using this tip, in addition to a curette, to clean out periodontal pockets is the fact that the ultrasonic waves burst the cell walls of the bacteria and break up calculus that has formed under the gums and the water flushes the debris from the pocket. The use of the correct tip reduces the amount of time required to perform the task. It only takes a few seconds to change the tips but the time saved by using the correct tool for the job is huge.
4. Power Scaler Technique
Use a very light grip on the hand piece remembering that your hand is only a guide for the tip. Using pressure or force only decreases the working power of the tip and can result in thermal damage to the tooth. Stay in constant contact with the tooth when scaling as the constant off and on action can cause a concussive injury to the tooth.
A good rule of thumb is to spend no more than seven seconds on a tooth before moving on to other teeth allowing the tooth to cool down. After cleaning several other teeth, the technician can return to the tooth if additional cleaning is required
Rationale: Power scalers range in speed from 8000 to 45,000 cycles/second resulting in an extreme amount of heat being generated. By limiting the pressure used and the amount of time spent on each tooth, the risk of thermal damage to the tooth is decreased.
5. Prophy Paste
Using the correct prophy paste is an important step in the cleaning process. It is recommended to use either fine or flour grit paste for the dental cleaning. You can purchase premade fine paste or make your own paste using flour pumice and glycerin and mixing it to a thick “cookie dough” consistency. Flour pumice can be purchased for your distributor.
Spend as much time polishing each tooth as spent scaling the tooth. The polisher does produce heat so spend no more than seven seconds on a tooth before moving on to other teeth. You can always come back to that tooth to finish. The prophy angle speed should be slow (3000 to 8000 rpms) and move the prophy cup slowly allowing the cup and paste to do the work. Using too high of rpms can result in thermal damage to the tooth and using too fast of movement will not result in a smooth surface.
Rationale: The ultrasonic scaler will leave micro etches on the tooth surface. These etches are the perfect location for bacteria to hide and propagate leading to more plaque and more calculus. Polishing is done to smooth those etches out giving less surface area for the plaque to adhere. Much like sandpaper, the courser grit of polish you have the more etches that may occur. Therefore it is important to use only fine or flour grit pumice to return that enamel to the smooth surface that was intended.
These are a few tips to help not only speed up the cleaning procedure but ensure that the procedure is a safe one for you and the patient.
About Mary Berg: BS, RVT, LATG, VTS (Dentistry)
Mary received her B.S. in Biology/Microbiology from South Dakota State University, her A.S. in Laboratory Animal Science from Redlands Community College, and her A.S. in Veterinary Technology from St. Petersburg College. She is a Charter member of the Academy of Veterinary Dental Technicians and received her Veterinary Technician Specialty in Dentistry in June 2006. Mary is currently serving as the treasurer of the AVDT, the President-elect of the KVTA, and is the 2017 President for NAVTA.
Mary fell into this profession totally by accident. After graduating from SDSU and following her military husband around the world, they settled in Lawrence, KS. She applied for a job as a microbiology lab assistant but wasn’t hired due to lack of experience. However, the company saw that she had held many administrative and management positions since graduation so they offered her a position as an administrative assistant for a research company that conducted research for companion animal oral products. Her career took off from there moving up to Vice President of Operations, all the while working as a researcher developing and implementing protocols to access the efficacy of products on plaque and calculus accumulations in dog and cats. . She spent 13 years in research and continues to work with companies to evaluate their products and serves on the VOHC council. In addition to her research background, she was the practice manager and dental specialist at a general practice for over 7 years, taught veterinary technology for 2 years and is currently the president of Beyond the Crown Veterinary Education, a veterinary dental consulting service as well as a national and international speaker and writer.
The most difficult part of her job is her chronic, genetic, inability to say no. She truly enjoys spreading the dental gospel and it’s hard to step back even when her schedule is full. The best thing about her job is that she gets the opportunity to meet so many wonderful people and help so many more pets than she did working in practice. She can now ensure that housands of pets get good oral care by helping the doctors, technicians and staff, understand the importance of providing good dental care to their patients. Her goal is to continue to spread the word of dentistry to all practices in the United States and elsewhere. She will be happy when each veterinary practice is doing a thorough oral examination, taking a full series of x-rays and understanding how to treat or when to refer pathology that is found!
Her advice to technicians is to get as much CE as possible, get involved in your professional organizations either at a local, state or national level and NEVER say no to an opportunity.
Mary lives on a small farm in Kansas with her husband and enjoys spending time relaxing at her pool with her grandchildren and menagerie of pets. When she’s not working she love to garden and along with her husband use the produce from the garden to create salsas, jellies, jams and other tasty treats as gifts for friends.
Her favorite textbook is Small Animal Dental Procedures for Veterinary Technicians and Nurses edited by Jeanne Perrone. Of course, chapter 2 is her favorite!! Wink, wink! Her favorite non-veterinary books include mostly murder mystery thrillers and the occasional mindless romance!
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